Global health emergency may be on the horizon over yellow fever

Posted May 10, 2016 by Karen Graham
Two Georgetown University professors are calling on the World Health Organization (WHO) take emergency steps to prevent the current outbreak of yellow fever from becoming a global health crisis.
People getting yellow fever vaccination in Angola.
People getting yellow fever vaccination in Angola.
oluwatosin owolabi
An estimated 200,000 people contract yellow fever worldwide every year, and of that number, 30,000 or more will die. Yellow fever is an acute viral disease transmitted by the Aedes mosquito, the same one that transmits Zika, chikungunya, and dengue fever.
Researchers Daniel Lucey, MD, MPH, and Lawrence O. Gostin, JD, of the O'Neill Institute for National and Global Health Law at Georgetown University outlined the extent to which the current outbreak of yellow fever in Africa could spread to other countries. In doing so, they are urging the WHO to take emergency steps now to prevent its spread before it becomes a global health emergency, reports Science News Online.
To date, yellow fever has killed 256 people in Angola and sickened over 2,000 people. The virus has already spread to other countries, according to Digital Journal, including Angola and Democratic Republic of Congo, which has 38 cases. China has nine cases brought into the country by people who had traveled to Angola, with two in Kenya and several more cases in Mauritania and Morocco.
On April 22, 2016, the Pan American Health Organization (PAHO) declared an epidemiological alert in South America. In Peru, this year, there have already been 20 cases of yellow fever reported, In 2013, there were 21 cases all year, and the last time there were over 20 cases reported was in 2007 when 29 cases were reported.
The vaccine problem
There is a vaccine for the yellow fever virus, and it is highly effective. The vaccine is currently distributed by WHO, other UN agencies, and a few non-profits, according to NBC News. "The global supply of yellow fever vaccines has been insufficient for years," the Pan American Health Organization, WHO's Americas arm, says.
According to a UNICEF report prepared in 2015, there are four manufacturers of the "WHO pre-qualified" yellow fever vaccine: Bio-Manguinhos in Brazil, Institut Pasteur de Dakar (Senegal), FSUE Chumakov in Russia and Sanofi Pasteur (France). Between the four manufacturers, about 80 million doses are made each year.
But there is an ongoing problem with the vaccine. There is just not enough on hand today to even immunize the people in Africa who need it most. The vaccination rates in Africa are below 50 percent because the current supply of vaccine can't meet the demand of 64 million doses per year.
In the paper, the Georgetown researchers note that it is important the WHO take better steps to manage global health emergencies, especially given the Ebola and Zika outbreaks and how they were handled. “The complexities and apparent increased frequency of emerging infectious disease threats, and the catastrophic consequences of delays in the international response make it no longer tenable to place sole responsibility and authority with the [WHO’s] director-general to convene currently ad hoc emergency committees,” they wrote.
The point being made is apparent. If yellow fever were to get started in China and other Southeast Asian countries, as well as other countries where yellow fever isn't endemic, the world would not be prepared. With the Zika virus, we waited too long before taking preventive measures, and it has turned into a global catastrophe.
The paper, "A Yellow Fever Epidemic - A New Global Health Emergency?" was published on May 9, 2016, in the Journal of the American Medical Association.